Results of improvement in adequacy of intermittent hemodialysis in uremic patients

Grzegorzewska AE, Banachowicz W, Leander M

Abstract

Purpose: Increasing number of patients, who need intermittent hemodialysis (IHD), is a great challenge for every society. The aim of study is to look if small increase in IHD adequacy is able to improve standard medical parameters. 
Material and methods: In 40 patients, Kt/V was monitored on-line during the middle IHD session in the week, 4  times in each of 6 consecutive months. In the first month of observation Kt/V was lower (1.09±0.02) than in the further months, in which Kt/V was increasing to 1.17±0.01. Blood count was estimated every month. At the beginning of study period, after 3 months and at the end of studies, dry body mass, body mass index (BMI), the blood pH and serum concentration of calcium, phosphate, intact parathormone (iPTH), total protein, albumin, cholesterol, iron, ferritin, urea and creatinine were determined. 
Results: The increase in Kt/V was accompanied by rising values of hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume, iron, blood pH before and after IHD session as well as by decreasing values of PTH. Statistically unchanged parameters included dry body mass, BMI, serum concentration of total protein, phosphate, cholesterol and ferritin as well as white blood cells and platelet count. There were correlations between Kt/V and serum concentrations of phosphate, PTH, ferritin, Hb and Hct, indicating that higher IHD doses were provided to patients in more advanced uremic state.
Conclusions: Even small increase in IHD adequacy leads to beneficial changes in management of uremic patients. 

Key words: 	Kt/V, blood morphology, pH, PTH, iron.